Full Given Name:                        Nickname                         Year Initiated


                                                                                                                    Area code - number
Preferred Name and Address                Home Telephone        
    Business Telephone   
    Cellular Telephone     
    email address             

Wife's Name:

Children / Ages (over 18 = Adult)

College Degree / Year              Second Degree / Year            Third Degree / Year
         

Occupation                                    Business Name                        Title
          

Military Service (Y/N)                  Medals / Citations
     

Favorite College Memory - see U of A Memory Button
Favorite PiKA Memory     - see Pi Kappa Alpha Button

Who do you keep up with from college            Their email address
                                  
                                  
                                  

Your Hometown                                                       Your high shcool
                                    

Parents Name                                                             Their current city and state